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Are you ready for winter's woes?

23 April 2018

Winter is on the way. It’s the season most associated with the hardship of illness such as influenza. Influenza or 'the flu' as it is commonly called, is usually identified as a mild illness, but for children under five years of age, pregnant women, and people over the age of 65 it can be severe and occasionally fatal.

‘Under 12 months and over 85-years-old are the age groups most affected. They end up being admitted more than other age groups into hospital emergency departments during the flu season. The problem is that because the flu is mostly mild in otherwise well adults it is easy for them to pass it on to their kids and elderly parents,' says Dr Liz Swinburn, an emergency specialist at Royal North Shore Hospital.

From April 2018, children between six months and under five years old will be eligible for free influenza vaccinations, following an additional NSW Government investment of $3.5 million to the state's $19.5 million vaccination program. Under Federal Government funding, older Australians over 65 and pregnant women can already access the flu vaccine for free under the National Immunisation Program.

2017 was a terrible flu season in both New South Wales and the Northern Sydney area. The Northern Sydney region had a 128% increase in total influenza notifications, with 14,619 residents infected compared to 6,408 residents in 2016. (http://www.health.nsw.gov.au/Infectious/Pages/data.aspx).

Given this, Sydney North Primary Health Network is playing its part to ensure the people of the Northern Sydney region are preparing for winter’s health challenges by increasing their rates of influenza vaccination. Now, during autumn’s milder days, is an excellent time to visit your general practitioner, have a check-up and get your flu vaccination for the winter ahead.

‘The problem with the flu is that we have not discovered the best way of treating it in its early stages. So, the best way to avoid it is through prevention, and the best way to prevent the flu is by getting the flu vaccination. There is also the broader issue of preventing the spreading of the flu to other people. If as many people as possible got a flu vaccination that would help prevent the severe spreading of influenza – especially in the winter months. The spreading of the flu also places a strain on our hospital system in particular,' say Neutral Bay GP and Chair of the Sydney North Primary Health Network, Dr Harry Nespolon.

It is generally reported that flu vaccination, proper hand hygiene, and appropriate coughing etiquette, is the best defence again the spread of influenza which is an extremely contagious virus.

The best defence against the spread of the extremely contagious influenza virus is flu vaccination, proper hand hygiene, and appropriate coughing etiquette.

‘Get immunised! If your work place provides free immunisations, ask them if your partner can get the vaccination as well. If he or she gets sick and can’t look after the kids, then you will need time off work so it’s a win-win for the employer. If you are unwell, use good hand hygiene and cover your mouth when coughing and sneezing. Try not to be in close contact with the young or old if you are sick, even if you are not that unwell,' says Dr Liz Swinburn.

Argentinian born mother of two Carolina Posadas has been an Australian citizen for 14 years and says her children have always been healthy in the flu season because they have always had the flu vaccination.

Carolina says that as a working woman herself, with a husband who works full time, and two school aged children, the main benefits of getting the flu vaccination are, 'that you don’t really get sick. Our children have never had the flu because we always vaccinate. And you don’t make other people sick because the flu is so contagious and can spread

so quickly. I also work with children in my job as a Spanish teacher, and my children go to day care, so we can’t afford to be flu carriers and spread it around.'

This is not the case for all children in the community.

‘Last year because I had my children vaccinated, when over half of their school class had the flu, neither of them got sick. We all try to make our children as healthy as possible by feeding them the right food and making sure they get enough rest. But diseases exist even if your children are healthy. They are also surrounded by other children and adults that might be sick and viruses and bacteria’s can be picked-up everywhere. And they are children, so they won’t always be doing things like washing their hands before they eat. So, it is really worth it to vaccinate your little ones,' says Carolina.

There is also some confusion about the common cold and the far more serious flu. We consulted the experts to dispel some myths.

‘We should be clear about what getting the flu vaccination means. It prevents you from getting influenza, not the common cold. The difference between a cold and the flu is that they are different viruses. The cold is milder than the flu but does have some very similar symptoms to start with such as aches, sneezing or light coughing. Influenza is a specific disease that can result in severe illness and in some cases death. The treatment of influenza is also not as robust as the prevention. Antivirals or antibiotics can sometimes make a patient with the flu more comfortable, but prevention is really the key,’ says Dr Nespolon.

‘The flu causes a more severe illness in some people and is also more transmissible,’ reinforces Dr Swinburn.

If there is a major outbreak of the flu, or pandemic flu as it is sometimes called, the hospitals become overwhelmed with people seeking treatment and mostly young children or people over the age of 65.

‘This means serious flu patients have to take hospital beds, and hospitals have to contain the spread of this highly contagious virus within their four walls as well. This all leads to a major strain on our hospitals, when best thing we can do as a community to stop people going to hospital with the flu in the first place is to ensure we are all getting a flu vaccination,’ says Dr Swinburn.

Neutral Bay resident June Campbell is 81 years old and understands the importance of staying well over the flu season at her age.

‘I think there is compelling evidence to show that without getting the flu vaccine we could become very ill and finish up as a statistic. I don’t want to end up in hospital on a ventilator like some of my friends have. I think it is also very unfair to your family, friends and neighbours not to have a flu injection because you could be spreading your germs onto them,’ say June.

‘I have had the flu before the flu vaccine became available and I was really sick. I mean really ill! So, I have had the flu jab every year it has been available ever since then. For older people who do things like ride public transport or attended events, people don’t bother covering their mouths half the time when they cough or sneeze during flu season and even when they do someone like me is still more susceptible to picking up all the germs that are around. As an older person over 65 where the flu vaccination is free, you are foolish not to get it because the life you save could be your own,' June continues.

However, some people are also concerned about how effective the flu vaccination really is. Last year there were large numbers of people who got the flu despite getting a vaccination.

‘Like all vaccinations, the flu vac is not perfect. However, there needs to be higher levels of community vaccinations to stop the flu being spread. As a society there needs to be no doubt that the people who get their vaccinations are much better off than the people who don’t,’ says Dr Nespolon.

Most people with the flu should not need to go to a hospital emergency department. It is always recommended that if you are concerned you may have strong influenza symptoms you should first contact your GP.

‘We prefer people with flu don’t come to emergency department unless they really need to, as they can infect other patients with cancer and on chemo who are very susceptible to the flu. We will ask for a mask to be applied to prevent others being exposed,’ says Dr Swinburn.

‘The hospitals during the flu season start to overflow and we should be leaving the hospitals and doctors to manage other important health conditions by helping them and getting the flu vaccine. We can prevent the flu. Other conditions and emergencies at hospitals cannot be prevented,’ says Dr Nespolon.

Additional information about the current vaccination schedules and links to evidence-based studies around the use and safety of vaccination can be found on the NSW Health website www.health.nsw.gov.au/immunisation